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Contact a Personal Application Coordinator
 

If you are a licensed psychologist and believe that you meet the criteria required for registration as a National Register Health Service Provider in Psychology, submit both parts of the Application Request Form below and we will email you access to your online application immediately.

Please note: If you are a former Registrant, you may qualify for reinstatement. If you are a student/trainee, request an application for the National Psychologist Trainee Register.

Tell us about yourself:

First Name
Last Name
Address One
Address Two
City
State/Prov/Terr
Zip/Postal Code
Phone
xxx-xxx-xxxx
E-mail (we must have a valid email address)
john_doe@acme.com
Create a Password (4-9 characters)
Confirm password

 

Please click continue and complete the brief survey form. As soon as you complete the survey form, we will email you access to your personalized online application.

Questions about the National Register? Contact: applications@nationalregister.org.

 

 

 

 

 
 

 
National Register | 1120 G St NW | Ste 330 | Washington DC 20005 | p: 202.783.7663 | f: 202.347.0550

 

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